Non-lab based projects

Non Laboratory based Honours and Masters Projects offered in 2017.

Projects listed below are ordered by Research Theme. Projects are available as Honours, and when available marked as Masters above the project description. If a project is offered as Masters only it is clearly marked as such.

Laboratory based Research Projects are found here.

Download a pdf copy of the Honours/Masters 2017 Handbook here.

Students are encouraged to directly contact Supervisors to further discuss the project, including providing a CV and academic transcripts to help the Supervisor determine if they are a suitable candidate.

Students should confirm their interest in the project with the Supervisor before nominating the project in their University application. Ensure the correct number corresponding to the project title is nominated for Department of Paediatrics in HATS.

Projects by Theme:

 

Cell Biology

37. How early-life adversity gets under the skin: the role of epigenetics
38. The impact of stress on mental health
39. Molecular classification tools to improve outcome in childhood cancers

Clinical Sciences

40. A clinical trial of lung protective ventilation during neonatal surgery and transport (Go with the flow 2)
41. Using complexity theory to model the newborn lung at birth
42. How do we help sick babies breathe? Understanding the role of ventilator synchronisation on lung protection
43. Does non-invasive ventilation alter ventilation patterns in preterm infants?
44. How do babies take their first breaths?
45. Understanding brain development in very preterm children using novel diffusion magnetic resonance imaging measures of white matter microstructure
46. Understanding brain development in very preterm children using in vivo myelin mapping based on magnetic resonance imaging
47. Does cortical thickness mediate cognitive deficits in ADHD.
48. Modelling the cardiovascular birth transition in vulnerable infants
49. Modelling cardiovascular development during childhood
50. "Are we truly engaged or is this a token?" Effective community engagement in research.
51. Measuring movement variability with inertial measurement units
52. Impact of pregnancy on women with Fontan circulation.

Genetics

53. Educational and training needs assessment of health professionals to inform implementation of genomic medicine
54. 'Genomic wellness' - exploring experiences and expectations of personal genomic testing in alternative medicine

Infection & Immunity

55. Risk factors for severe childhood pneumonia in Lao PDR
*New* 75. Can we determine which children with cellulitis need intravenous antibiotics?

Population Health

56. Linking early life environment with child health: a longitudinal twin study
57. The epidemiology of childhood food allergy and other allergic diseases
58. Habitual dietary intake, snacking behaviour and oral health in 11-12 year old children and their parents
59. Parent-child concordance in oral health
60. Delving into adolescents' dispositional optimism/pessimism and exploring its association with cardiovascular health in 11-12 year olds: a population-based study
61. Delving into adolescents' dispositional optimism/pessimism and exploring its association with health-related quality of life in 11-12 year olds: a population-based study
62. Delving into adolescents' dispositional optimism/pessimism and exploring its social determinants in 11-12 year olds: a population-based study.
63. Changes in adolescents' time use over the past decade
64. How early life factors influence cardiovascular function at age 11-12 years: a population-based longitudinal study
65. How 10-year diet and body composition trajectories influence bone health at two important life stages: Early adolescence and mid-life
66. How 10-year diet and body composition trajectories influence lung function at two important life stages: Early adolescence and mid-life
67. Unnecessary use of pathology testing in hospital admissions.
68. Insights into the conundrums of managing mild congenital hearing loss
69. Evaluation of a new model of care for children with bowel and bladder dysfunction: pathways of care and patient experience.
70. Trends in additional health and developmental needs over time: Evidence from three cohorts of the Australian Early Development Census
*New* 74. Unnecessary use of imaging testing in hospital admissions

 

Project Descriptions:

37. How early-life adversity gets under the skin: the role of epigenetics

Dr Delyse Hutchinson
Population Health Studies of Adolescents
Population Health
E delyse.hutchinson@mcri.edu.au

 

Available as Masters Project: Yes

Increasing evidence highlights the importance of the early life environment in shaping our health and risk for disease in later life. Under this Developmental Origins of Health and Disease Model, exposures occurring during the crucial phase of early life can become biologically embedded, with the potential for long-term effects. Epigenetics which can regulate gene expression without altering the underlying DNA sequence, could be one mechanism by which these effects occur. Indeed, the epigenome of the developing fetus may be particularly vulnerable to exposures received in utero, and early-life stress has been linked with a modified epigenetic profile in the neonate. Epigenetic marks might also be valuable tools used to predict future health outcomes.

The Australian Temperament Project (ATP) is one of Australia's oldest longitudinal studies of social and emotional development. The study has followed 2000 infants and parents across 30 years (15 waves) from 1983 and has detailed information on temperament, social and emotional development, and family and social context. It is now following cohort offspring to create a 3-generation resource (ATP Generation 3 Study), with offspring assessments in trimester 3, at birth, 8 weeks, 12 months and beyond. At 12-months, infants undergo a clinical assessment with their primary caregiver to assess attachment behaviour, which takes into account both infant temperament style and parent care giving behaviour. A DNA sample is also collected, allowing DNA methylation (a key epigenetic mark) to be measured.
This study will use new epigenome-wide methylation data gathered on a sub-set of infants assessed at 12 months, comparing two extreme groups based on their attachment classification. The aim will be to investigate the role of DNA methylation in mediating the association between prenatal exposure and infant attachment security. This project would suit a student interested in epigenetics and keen to develop skills in data analysis.

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38. The impact of stress on mental health

 

Available as Masters Project: Yes

Depression is a major public health problem with high prevalence rates worldwide and an increased risk of comorbidity and mortality. Depression is considered a dimensional disorder whose severity is determined by multiple genes with small effects and complex interactions between genetic predisposition and environmental factors. Indeed, it has been shown that stressful or traumatic life events, particularly those in childhood, can lead to an increased risk of depression in later life for certain genetically predisposed individuals. The molecular mechanism for this gene-environment interaction however remains unknown, but epigenetic mechanisms are likely to play a role. This project, as part of a wider collaboration with a French research team, will make use of data gathered from the longitudinal population-based ESPRIT study.

This study, currently in its fifteenth year, has gathered extensive biological, structural (MRI) and clinical data, including past and current depression diagnosis, detailed histories of stressful and traumatic events across the lifetime, as well as physiological markers of stress response (cortisol measured under basal and stress conditions) and genotyping data. DNA methylation data is also available for a number of candidate genes. This project will focus on the role of stress in depression, using extensive data already collected in this study. It will suit a student interested in epidemiology and biological psychiatry, and will enable then to develop skills in data analysis.

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39. Molecular classification tools to improve outcome in childhood cancers

Dr Enes Makali
Centre for Epidemiology and Biostatistics
Melbourne School of Population and Global Health
E emakalic@unimelb.edu.au

 

Available as Masters Project: Yes

The accurate classification of individual cancer patients into risk classes that predict long-term outcome at diagnosis is key to making informed therapeutic decisions. In recent years both gene expression and genetic data have been successfully used to complement the clinical and histological criteria traditionally used in such prediction. Many "molecular signatures" have been developed, primarily in an adult cancer setting. In contrast to their adult counterparts, childhood tumours show a relatively low mutational burden, despite exhibiting widespread gene dysregulation. Much of this is due to extensive epigenetic changes, including changes in DNA methylation profile.

The aim of this study is to use modern machine learning algorithms to develop molecular classification tools based on DNA methylation, gene expression and genetic variation data that accurately predict outcome in childhood cancers. Such classifiers are key to improving outcome in childhood cancers that represent the second most common cause of childhood mortality in developed countries. This project would is suitable for students with a background in Computer Science and/or Machine-based learning.

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Clinical Sciences

 40. A clinical trial of lung protective ventilation during neonatal surgery and transport (Go with the flow 2)

Dr Prue Pereira
Neonatal Research
Clinical Sciences
E prue.pereira@mcri.edu.au

 

Available as Masters Project: Yes

The newborn lung is particularly prone to serious lung injury when sick or diseased. Increasingly, clinicians are aware of the potential of the mechanical ventilators to damage the fragile newborn lung. This creates a paradox, as neonatal ventilators are often lifesaving treatments in this population. Excessive tidal inflations (volutrauma) are a particularly injurious mechanism. Consequently, the limitation of tidal inflations to 4 - 8 mL/kg is an established method of maximising lung protection in babies receiving Neonatal Intensive Care. We have recently shown that for babies leaving the NICU for surgery delivered tidal volumes are variable, and often outside of the accepted safe range. This project is a clinical trial of direct feedback clinical monitoring of lung function during transport and surgery in babies versus current therapy to determine if this results in more tidal inflations being in the lung protective range. The project will use our groups existing methods of recording high-fidelity physiology measurements of lung function. It is hoped that this will lead to improved practice for this vulnerable population in the RCH and international guidelines. The successful candidate will have the potential to access additional resources and funding support through the NHMRC Preterm Infants Centre of Research Excellence.

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41. Using complexity theory to model the newborn lung at birth

Dr Prue Pereira
Neonatal Research
Clinical Sciences
E prue.pereira@mcri.edu.au

 

Available as Masters Project: Yes

The very first breaths of life are one of the most remarkable events in human life. ery quickly the lung needs to adapt from a liquid-filled state to an air-filled one and start the cascade of events that allow the heart and other organs begin ex-utero life. The physiological mechanisms that underpin this respiratory process are multi-factorial and understood. Unfortunately, our understanding of these processes is limited to models and concepts that consider the lung as a whole. In reality the lung is millions of alveoli, each with their own physiological mechanical properties. Increasingly researchers are acknowledging that the respiratory processes at birth are intrinsically heterogeneous at an alveoli level. Recently advanced imaging methods have become available to describe the physiological transition of the lung at an almost alveolar level. This provides a unique data set that can be exploited to better our understanding of the lung during its first breathes of life. Complexity theory is one method that maybe useful in describing the behaviour of the lung at birth at an alveolar level. Valid complexity theory models of the lung would allow the development of better mechanical ventilator and monitoring algorithms and, hopefully, improved clinical care for sick babies at birth. This project aims to evaluate and test different complexity theory models of alveolar behaviour at birth in an existing data set of 200 high-fidelity regional lung imaging recordings (using electrical impedance tomography) of preterm lambs during the first breathes of life. The project is suited to a candidate with a mathematical background wishing to develop practical mathematical solutions to an important human problem.

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42. How do we help sick babies breathe? Understanding the role of ventilator synchronisation on lung protection

Dr Prue Pereira
Neonatal Research
Clinical Sciences
E prue.pereira@mcri.edu.au

 

Available as Masters Project: Yes

The diseased newborn lung is particularly prone to injury that can persist throughout life. Increasingly, we are aware that allowing a mechanical ventilator to synchronise with a baby's own breathing pattern reduces the risk of lung injury. Ventilation within the diseased lung is complex and rarely the same throughout the lung. This project aims to understand how synchronisation influences the behaviour of tidal ventilation throughout the lung. It will involve directly studying newborn babies receiving Intensive Care at the Royal Children's and Women's Hospitals using advanced lung imaging techniques. The student will take detailed recordings of lung mechanics and ventilation in babies receiving mechanical ventilation and describe the breath-to-breath characteristics of synchronised and unsynchronised breaths to determine whether lung protection is being achieved and whether it is uniform within the lung. The successful candidate will have the potential to access additional resources and funding support through the NHMRC Preterm Infants Centre of Research Excellence.

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43. Does non-invasive ventilation alter ventilation patterns in preterm infants?

Dr Louise Owen
Neonatal Research
Clinical Sciences
E louise.owen@mcri.edu.au

Dr Prue Pereira
Neonatal Research
Clinical Sciences
E prue.pereira@mcri.edu.au

 

Available as Masters Project: Yes

Preterm infants often have trouble breathing after birth and need respiratory support. But, the preterm lung is particularly prone to injury. Increasingly clinicians are using non-invasive ventilation (NIV) as a gentler way of helping preterm babies' breathe. There are now different types of NIV; CPAP, high-flow nasal cannula, nHFO and NIPPV. Each is slightly different and clinical trials have not shown a huge efficacy difference. This project aims to understand how each influences the behaviour of tidal ventilation throughout the lung. It will involve directly studying newborn babies receiving Intensive Care at the Royal Children's and Women's Hospitals using advanced lung imaging techniques. The student will take detailed recordings of lung mechanics and ventilation in babies receiving mechanical ventilation and describe the breath-to-breath characteristics of in babies receiving different types of NIV to determine whether tidal ventilation differs within the lung, and conform with our understanding of lung protection. The successful candidate will have the potential to access additional resources and funding support through the NHMRC Preterm Infants Centre of Research Excellence.

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44. How do babies take their first breaths?

Dr Louise Owen
Neonatal Research
Clinical Sciences
E louise.owen@mcri.edu.au

Dr Prue Pereira
Neonatal Research
Clinical Sciences
E prue.pereira@mcri.edu.au

 

Available as Masters Project: Yes

Birth involves the successful transition from a fluid-filled fetal lung state to a lung that is aerated (air filled). This needs to occur quickly to allow other organs to start working. About 10% of term babies, and most preterm babies, do not aerate their lungs properly at birth. These babies often need help with their breathing. We do not yet fully understand how babies take their first breathes at birth and why some have problems. This observational study aims to describe how babies aerate their lungs at birth and develop normal breathing. It will use a new state-of-the-art lung imaging system developed at the MCRI to study newborn babies in the Delivery Room of the Royal Women's Hospital. The successful candidate will then analyse the ventilation, aeration and filling characteristics of each imaged lung. This will help us determine whether the human lung starts breathing in the way we think it does. The successful candidate will have the potential to access additional resources and funding support through the NHMRC Preterm Infants Centre of Research Excellence.

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45. Understanding brain development in very preterm children using novel diffusion magnetic resonance imaging measures of white matter microstructure

Ms Claire Kelly
Victorian Infant Brain Studies (VIBeS)
Clinical Sciences
E claire.kelly@mcri.edu.au

 

Available as Masters Project: Yes

Scientific question: Very preterm birth (less than 30 weeks of gestation and/or less than 1250 grams birth weight) is associated with brain injury, altered brain development and long-term deficits in cognitive, behavioural and motor function. Novel magnetic resonance imaging (MRI) analysis techniques are emerging that enable in vivo quantification of the brain's white matter microstructural and axonal properties. The aims of this study are to determine whether white matter microstructure is altered in very preterm-born children compared to healthy term-born children at 13 years of age, and to determine if white matter microstructure is associated with concurrent cognitive, behavioural and motor functioning in very preterm children.

Basic experimental approach / general tasks: Advanced diffusion MRI techniques can be used to generate quantitative measures of the brain's white matter microstructure, such as axon density. Furthermore, advanced neuroimaging techniques enable analysis of microstructure measures across the entire white matter of the brain and within specific white matter fibre pathways.
General information: The Victorian Infant Brain Study (VIBeS) research group explores brain injury and brain development in premature infants using state-of-the-art neuroimaging techniques. We also focus on identifying factors that influence brain maturation and determining how brain maturation contributes to neurobehavioural development. Furthermore, the team is involved with developing interventions to improve outcomes for premature children.

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46. Understanding brain development in very preterm children using in vivo myelin mapping based on magnetic resonance imaging

Ms Claire Kelly
Victorian Infant Brain Studies (VIBeS)
Clinical Sciences
E claire.kelly@mcri.edu.au

 

Available as Masters Project: Yes

Scientific question: Very preterm birth (less than 30 weeks of gestation and/or less than 1250 grams birth weight) is associated with brain injury, altered brain development and long-term deficits in cognitive, behavioural and motor function. Magnetic resonance imaging (MRI) analysis techniques are emerging that enable in vivo quantification of the brain's white matter myelin content. The aims of this study are to determine whether white matter myelin content is altered in very preterm-born children compared to healthy term-born children at 13 years of age, and to determine whether white matter myelin content is associated with concurrent cognitive, behavioural and motor functioning in very preterm children.

Basic experimental approach / general tasks: Myelin mapping is an advanced neuroimaging technique that involves combining T1-weighted and T2-weighted magnetic resonance images to non-invasively examine myelin content. Furthermore, advanced neuroimaging techniques enable quantitative analysis of myelin content across the entire white matter of the brain and within specific white matter fibre pathways.
General information: The Victorian Infant Brain Study (VIBeS) research group explores brain injury and brain development in premature infants using state-of-the-art neuroimaging techniques. We also focus on identifying factors that influence brain maturation and determining how brain maturation contributes to neurobehavioural development. Furthermore, the team is involved with developing interventions to improve outcomes for premature children.

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47. Does cortical thickness mediate cognitive deficits in ADHD

Mr Charles Malpas
Developmental Imaging
Clinical Sciences
E charles.malpas@mcri.edu.au

 

Available as Masters Project: Yes

The neurobiological substrate of attention deficit hyperactivity disorder (ADHD) is an area of active research. Compared to typically developing children, those diagnosed with ADHD demonstrate deficits on tasks of sustained, complex, and divided attention. A number of studies have reported differences in brain structure between children with ADHD and typically developing controls. As a part of the Neuroimaging of the Children's Attention Project (NICAP) study, we are in the process of collecting longitudinal neuroimaging data on children with and without ADHD from ages 9.5 to 12.5 years. The aim of this project is to investigate to what degree these differences in brain structure explain the observed cognitive impairments.

Working in the developmental imaging group, the student will learn to analyse structural magnetic resonance imaging (MRI) data, with a particular emphasis of estimating cortical thickness. This project is suitable for a highly motivated student with an interest in neuroimaging. Strong computing skills are required, along with a willingness to learn new skills (such as basic programming and use of the command line).

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48. Modelling the cardiovascular birth transition in vulnerable infants

Assoc. Prof. Joseph Smolich
Heart Research
Clinical Sciences
E joe.smolich@mcri.edu.au

 

Available as Masters Project: Yes

Birth is arguably the most crucial and most complex event of life. Immediately after birth, rapid and profound changes occur in the cardiovascular system to facilitate the shift from placental respiration to breathing with the lungs. However, premature birth, congenital heart disease and/or birth complications (such as fetal or newborn asphyxia) can cause problems with the birth transition that may have long lasting consequences for the child (e.g. brain damage, requirements for intensive care, greater long-term risk of cardiovascular disease). The precise nature of the perinatal cardiovascular complications, and how they might be treated better or avoided altogether, are very difficult to study in human babies due to ethical and practical constraints.

In this project, the student will develop a state-of-the-art computational modelling platform for studying the birth transition and challenges encountered by vulnerable infants. A key benefit of a modelling approach is the lack of ethical constraints and great flexibility in studying the problem. The project will be integrated with world-leading work by our group on fetal modelling and experimental studies of the birth transition in lambs, and will benefit from our links with the neonatal intensive care unit at the Royal Children's Hospital.

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49. Modelling cardiovascular development during childhood

Assoc. Prof. Joseph Smolich
Heart Research
Clinical Sciences
E joe.smolich@mcri.edu.au

 

Available as Masters Project: Yes

It is increasingly being recognised that the precursors to adult cardiovascular disease begin in childhood. However, we currently have limited information about the normal development of the cardiovascular system during childhood and how this normal development is interrupted by problems such as congenital heart disease.

One-dimensional modelling is a powerful tool for studying the cardiovascular system but currently no models of the growing circulation exist. Based on existing state-of-the-art models of the adult and newborn cardiovascular systems, developed by our group, the student will incorporate childhood growth and physiological development. The model will be validated against measurements in children. The resulting model will allow simulation of blood pressure and flow throughout the circulation of a representative normal child at any time during childhood. By perturbing parameters of the normal development model, new insights will be gained into problems faced by children with congenital heart disease and why some children have a high risk of developing cardiovascular disease as adults.

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50. "Are we truly engaged or is this a token?" Effective community engagement in research.

Dr Elise Davis
Centre for Health Equity
Melbourne School of Population & Global Health
E eda@unimelb.edu.au

 

Available as Masters Project: Yes

How can researchers best work with the community to benefit from their experience and incorporate feedback into research programs? What makes for good engagement, and where does it typically go wrong? How can the process be improved to support a satisfying and constructive relationship between researchers and community members?

The NHMRC-funded Centre of Research Excellence in Cerebral Palsy (CRE-CP) is a five year project that aims to improve the health and well-being of all people affected by cerebral palsy and their families. One of the CRE-CP core values is to involve parents, carers and persons with cerebral palsy in all aspects of the program to ensure outcomes are meaningful and relevant to the end-users. Community engagement is a widely embraced concept, however strategies that have proved effective remain under-explored.
The CRE-CP has an opportunity for an honours or masters student to work alongside researchers, community representatives and the CRE-CP Community Coordinator to explore what factors contribute to successful community engagement, and to make recommendations that can be adopted by other research groups.
The student will work closely with leading researchers, clinicians and our experienced team of community representatives to review current literature, and then hold interviews and focus groups to gather data on barriers and how these can be overcome. The student will document the lessons learned and contribute to the literature on meaningful community engagement across the disability research field.

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51. Measuring movement variability with inertial measurement units

Available as Masters Project: Yes

The purpose of this project is to develop and validate an algorithm to determine movement variability from one inertial measurement unit.
The algorithm will be validated against a state of the art motion capture system available at The Royal Children's Hospital. We will use the algorithm to study the movement variability of a range of simple grasping task in typically developing children. The longer term objective is to compare the movement variability of typically developing children with that of children with cerebral palsy.

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52. Impact of pregnancy on women with Fontan circulation

Dr Dominica Zentner
Royal Melbourne Hospital
E dominica.zentner@mh.org.au

Dr Rachael Cordina
Royal Prince Alfred Hospital
 

 

Background.
THE EXTRAORDINARY FONTAN CIRCULATION. Babies born with a single pumping heart chamber can survive if they undergo a series of operations, culminating in the Fontan procedure after which the desaturated blood goes directly to the lungs without being pumped by the heart. The results of this operation have been far better than expected. It is estimated that between 50-70 000 such patients are alive in the world, 40% of them aged above 18. Many of these young women seek to become mothers, but with half a heart, this may be a real challenge both for their foetus and themselves. The possible longer term effects of pregnancy in this population are unknown.
We have created the Australia and New Zealand Fontan Registry, the largest database of such patients in the world and are leading the research in this field. Women with a Fontan circulation have a much higher risk of miscarriages, prematurity and maternal morbidity.
WE STILL DO NOT KNOW IF THEIR HEARTS WILL SUFFER LONG-TERM DAMAGE FROM SUPPORTING PREGNANCIES.

The project.
We have information on 20 women who reported a total of 40 pregnancies. We want to collect very detailed analysis of their heart including echocardiography and exercise capacity. We will analyse the evolution of their cardiac function over time from before to several years after the pregnancy. We will then find very similar patients with a Fontan but no pregnancy and compare these groups to understand the later impact of pregnancy on Fontan hearts.
The team.
We expect this Honours student to get two publications from this work. We have a high track record of successful supervision of Honours students, Masters, and PhD. We have been supporting students in their subsequent careers and expect them to be an integral part of our team.

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Genetics

53. Educational and training needs assessment of health professionals to inform implementation of genomic medicine

Dr Amy Nisselle
Molecular Development
Cell Biology
E amy.nisselle@mcri.edu.au

Dr Belinda Mcclaren
Molecular Development
Cell Biology
E belinda.mcclaren@mcri.edu.au

Dr Clara Gaff
Clinical Genetics Research (BLC)
Genetics
E clara.gaff@mcri.edu.au

 

Available as Masters Project: Yes

The successful implementation of genomics in healthcare will depend on the availability of a workforce to deliver genomic medicine and its acceptance on both clinical and ethical grounds by health professionals, patients, their families and society.
It is widely accepted that the Australian health system workforce is not sufficiently literate in genomics to optimally incorporate it into their current roles. The limited number of genetic and other expert health professionals cannot meet demand. Australia needs an integrated approach to workforce development in genomic medicine to minimise duplication of effort, leverage existing resources, and support good clinical and ethical practice.
Program 4 of the Australian Genomics Health Alliance (funded by the NHMRC) is focussed on understanding the needs of health professionals who would contribute to the genomic workforce or be impacted by genomics.
The aim of this project is to develop a survey to inform strategies around education and training of health professionals to enable them to incorporate genomic medicine into their future practice.
This project (suitable for Honours or Masters) would involve creating a needs assessment survey, based on existing literature and other data obtained by Program 4, which would ultimately be disseminated to health professionals. Health professional groups could include non-genetics medical specialists, general practitioners, nursing and allied health professionals. In the first instance the student/s would design develop a draft online survey which would then undergo a process of iterative revision with content and educational experts (a process known as the Delphi technique) and piloted with a small group of health professionals. In the case of a Masters project, the survey would then be disseminated to a large group of relevant health professionals and the responses/data analysed.

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54. 'Genomic wellness' - exploring experiences and expectations of personal genomic testing in alternative medicine

Ms Chriselle Hickerton
Genetics Education & Health Research
Genetics
E chriselle.hickerton@mcri.edu.au

 

This project is embedded in the GeNIOz study (Genomics: National Insights of Australians), funded by the Australian Research Council. Overall, GeNIOz seeks to understand Australians' experiences and expectations of personal genomics, with the aim of developing education support for informed decision-making by the general public.
In the last year, there has been a surge of personal genomic testing offered in Australia through naturopath and other alternative medicine practitioners, with limited (if any) genetic counselling support/training. Many of the claims of the marketing around these tests have little grounding in evidence-based research or practice.

This Honours project will involve analysing the relevant content of 'genomic wellness' websites for accuracy and claims of personal and clinical utility, and exploring the experiences and attitudes of people who have had, or considered having, a 'genomic wellness' test offered through an alternative medicine practitioner. Participants will be identified through their responses to a current online survey, and then contacted for telephone interviews. This involves undertaking qualitative analytical methods and the student will be trained and supported in this methodology by the supervisors.
The outcomes from this research will inform the overall GeNIOZ study, specifically around how personal genomic testing for 'genomic wellness' is being offered in Australia, and how best to develop unbiased educational material to support people when making decisions about this type of DNA testing.
 

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Infection and Immunity

55. Risk factors for severe childhood pneumonia in Lao PDR

Pneumonia is the commonest infectious disease causing childhood death worldwide. Pneumococci are responsible for about 1/3 of all pneumonia deaths.

We have a number of studies in Laos documenting the impact of pneumococcal vaccine on pneumococcal disease in Laos, including a prospective study of all childhood pneumonia admissions to determine how carriage surveillance can be used to document herd immunity. In this study we will be using that data to describe the risk factors of severe pneumonia.

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75. Can we determine which children with cellulitis need intravenous antibiotics?

This is the third part of a 3-part project.

Background and aims:
There are currently no standardised guidelines for treating cellulitis in children particularly, whether oral or intravenous (IV) antibiotics should be used. Admission to hospital for IV antibiotics can lead to hospital-acquired infections, family disruption and resource implications. We aimed to develop a scoring system using clinical features to differentiate between the need for IV and oral antibiotics in children with cellulitis.
Cohort 1 - score derivation: the clinical features of cellulitis and decisions to use IV or oral antibiotics were used to develop a scoring system
Cohort 2 - validation: patients with cellulitis were observationally used to validate the score
Cohort 3 - clinical application: patients will prospectively have the clinical score applied to them to determine how the score functions when applied clinically.
This project will encompass cohort 3.

Methods: All patients aged 3 months-18 years presenting to the Royal Children's Hospital Emergency Department with cellulitis will be assessed for inclusion. Patients who would automatically receive IV antibiotics for complicated/severe cellulitis will be excluded. Physicians will be educated about the score and will be asked to apply it when determining whether to use IV or oral antibiotics. Data will be collected: demographics, prior oral antibiotics, cellulitis size and systemic symptoms/signs. Subjective scores for severity of erythema (0-5), tenderness (0-5) and swelling (0-3) will be obtained.

Outcomes: re-presentation, change from oral to IV and duration of treatment.

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Population Health

56. Linking early life environment with child health: a longitudinal twin study

Dr Katrina Scurrah
Plastic Surgery Research
Cell Biology
E katrina.scurrah@mcri.edu.au

 

What happens in the womb can last a lifetime. Factors such as maternal diet and lifestyle during pregnancy are linked with a lifetime risk for chronic diseases, ranging from cardiometabolic to neurodevelopmental. Twin studies are ideal for studying such diseases because of their ability to resolve genetic, shared (maternal and early life) and individual environments. For example, comparing twins within a pair enables regression of within-pair differences in pre- and perinatal factors on within-pair differences in health outcomes, controlling for genetics and shared environment.

This project takes advantage of the unique data collected in the Peri/postnatal epigenetic Twin Study (PETS) of Drs. Craig and Saffery. In this study, women pregnant with twins were recruited in mid gestation, extensive data were collected on maternal diet and lifestyle and on the twins themselves multiple times in utero, at birth, 18 months and 6 years of age. This rich dataset enables a number of potential projects based on the student's interests and is ideal for a wide range of disciplines from genetics to medicine. Our main outcomes of interest are cardiometabolic (weight, height, skin fold thickness, blood pressure) and infectious and other illnesses. Specific research questions include, but are not limited to:
1. Are shared maternal factors such as smoking, gestational weight gain, diet and stress associated with health outcomes in 6 year-olds?
2. Are twin-specific prenatal factors such as intrauterine growth rate, placenta weight, and location of cord insertion into the placenta associated with within-pair differences in health outcomes in 6 year-olds?
3. Do factors such as maternal smoking in pregnancy predict within-pair discordance in child health outcomes?
4. Are twin zygosity, sex and chorionicity associated with child health outcomes?
Each specific research project will be supported by experts in specific domains of child health.

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57. The epidemiology of childhood food allergy and other allergic diseases

Dr Rachel Peters
Gastro & Food Allergy
Population Health
E rachel.peters@mcri.edu.au

 
 

An epidemic of allergic diseases has occurred, marked by the rapid rise of asthma, eczema and allergic rhinitis during the 1990s, followed by an alarming increase in food allergies in the 2000s. The determinants, natural history and impact of allergic diseases, in light of the increased prevalence, remain largely unknown. This includes whether the new wave of infant food allergy will persist into later childhood, and the role of food allergy in the development of other allergic diseases e.g. asthma.

The HealthNuts study is the world's largest population-based, longitudinal study of food allergy and other allergies in early childhood. At 12-months of age, 5300 infants underwent skin-prick testing, and all positives proceeded to hospital-based food challenge to test for food allergy. The cohort has been followed up at ages 4 and 6 years. By the end of 2016, all the HealthNuts children will have turned 6 and completed follow-up. Objective data on the full range of allergic outcomes (asthma, eczema, allergic rhinitis and food allergy) including lung function testing, food challenges and skin prick tests, as well as other measures of their physical and psychosocial health and healthcare utilisation across the early years, will be available.
A position is available for an honours student to investigate a number of potential research questions related to the determinants, natural history and consequences of food allergy and other allergic diseases. This is an exciting opportunity to undertake epidemiological research in a large, longitudinal study. Possible research projects include:

  • To explore the role that food allergy plays in the development of other allergic diseases in the first 6 years
  • To describe the natural history of infantile eczema, including identifying predictors of persistence and resolution
  • Which children with early-life wheezing will developing asthma at age 6 years?

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58. Habitual dietary intake, snacking behaviour and oral health in 11-12 year old children and their parents

Dr Jessica Kerr
Community Health Services Research
Population Health
E jessica.kerr@mcri.edu.au

 

OVERVIEW:
Children and adults with unhealthy eating patterns are at risk for poor oral health, but the literature is limited in two ways. First, previous studies have had small samples making it difficult to draw population-level conclusions that might influence intervention strategies. Second, no research has been able to study how naturalistic food choices, habitual dietary intake and/or dietary trajectories relate to oral health at a population level. This is because, until now, it has been technically too challenging to comprehensively measure diet, eating behaviour and oral health profiles in community samples.
Working within the Longitudinal Study of Australian Children's Child Health CheckPoint, this project will address these current limitations, while also providing a rare opportunity to work within one of Australia's most important and exciting national research projects.
OBJECTIVES:
The Child Health CheckPoint provides a snapshot of oral health and eating behaviour in children 11-12 years and their midlife parents (N = 1200). Children and parents participate in a Food Stop which provides a unique opportunity to observe and accurately quantify the parents' and children's food choices and consumption data. This data (together with childhood dietary trajectories) will be correlated with measures of oral health via dental photographs taken during Tooth Booth.
AIMS:
In (a) 11-12 year olds and (b) midlife adults, is oral health (gum health, overt caries) predicted by:
I. Self-reported habitual diet
ii. Observed intake in a controlled snack situation (sugar, total grams intake)
iii. Childhood dietary trajectories (children only)

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59. Parent-child concordance in oral health

Dr Jessica Kerr
Community Health Services Research
Population Health
E jessica.kerr@mcri.edu.au

OVERVIEW:
The concordance between child and parent oral health is poorly understood - the literature is limited in two ways. First, previous community studies have had small samples making it difficult to understand the epidemiology of oral health in these age groups. Second, no research has conducted the same assessment of child and parent oral health at the same time point at a population level. This is because, until now, it has been technically too challenging to comprehensively measure oral health profiles in large community samples.
Working within the Longitudinal Study of Australian Children's Child Health CheckPoint, this project will address these current limitations, while also providing a rare opportunity to work within one of Australia's most important and exciting national research projects.
OBJECTIVES:
The Child Health CheckPoint provides a snapshot of oral health in children 11-12 years and their midlife parents (N = 1200). Children and parents participated in Tooth Booth where a series of 2D dental photographs were taken and stored for later analyses.
AIM 1: To describe the cross-sectional epidemiology of oral health in a population representative cohort of:
a) Australian 11-12 year olds
b) One parent/caregiver of each child
AIM 2: To examine parent-child concordance in oral health.

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60. Delving into adolescents' dispositional optimism/pessimism and exploring its association with cardiovascular health in 11-12 year olds: a population-based study

Dr Kate Lycett
Community Health Services Research
Population Health
E kate.lycett@mcri.edu.au

Professor Timothy Olds
School of Health Sciences
University of South Australia
E Timothy.Olds@unisa.edu.au

INTRODUCTION:
Dispositional optimism or pessimism refers to an individual's tendency to generally expect positive or negative outcomes. It is thought to be reasonably stable over time and to be influenced by interactions between environment and genetics. High levels of optimism have been shown to be associated with a range of positive outcomes (eg physically, psychologically and academically). In adults, low dispositional pessimism, rather than high optimism, was recently shown to be associated with ideal cardiovascular health. Understanding whether this association begins in adolescence is important for understanding the genesis of cardiovascular disease, given that poor cardiovascular health begins early in the life course. Until recently risk factors for cardiovascular disease have typically focused on lifestyle factors (eg smoking). However, these factors only account for 50% of the attributable risk of cardiovascular disease, thus attention is turning to the risk and protective role of psychosocial health. Using rich qualitative data paired with cutting edge measures of cardiovascular health, we have a unique opportunity to gain insights into Australian adolescents' dispositional optimism/pessimism and its association with cardiovascular health.
RESEARCH AIMS:
To examine (1) Australian adolescents' dispositional optimism or pessimism, and (2) the extent to which it cross-sectionally predicts cardiovascular health (macro- and micro-vascular structure, vascular function and adiposity) at age 11-12 years.
METHODS: 
Data will be drawn from The Child Health CheckPoint's (n=1864) Life@25 data (ie handwriting sample where children were asked to write about their life at age 25) and its rich physical measures of cardiovascular health. The student will make a major contribution to scoring Life@25 data and work closely with a strong interdisciplinary team.
IMPACT OF RESEARCH:
The study will likely draw international attention given the large, high quality data available. Findings are likely to inform the genesis of cardiovascular disease and be disseminated in a high quality journal.

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61. Delving into adolescents' dispositional optimism/pessimism and exploring its association with health-related quality of life in 11-12 year olds: a population-based study

Dr Kate Lycett
Community Health Services Research
Population Health
E kate.lycett@mcri.edu.au

Professor Timothy Olds
School of Health Sciences
University of South Australia
E Timothy.Olds@unisa.edu.au

Dispositional optimism or pessimism refers to an individual's tendency to generally expect positive or negative outcomes. It is thought to be reasonably stable over time and to be influenced by interactions between environment and genetics. High levels of optimism have been shown to be associated with a range of positive outcomes (eg physically, psychologically and academically), while high levels of pessimism have been shown to be linked to poorer outcomes. However, much of this research has focused on individuals with chronic illnesses. Understanding whether optimism/pessimism effect health-related quality of life (HRQL) in the population could offer novel insights into interventions to improve general health and wellbeing. This seems particularly important in adolescence, as the recent Lancet Commission into adolescent health argues that a broader 'lens' on their lives is required that goes beyond traditional 'health problems'. Using rich qualitative data paired with standardised utility and profile measures of HRQL, we have a unique opportunity to gain insights into Australian adolescents' dispositional optimism/pessimism and its association with HRQL.

RESEARCH AIMS:
To examine (1) Australian adolescents' dispositional optimism or pessimism, and (2) the extent to which it cross-sectionally predicts HRQL at age 11-12 years.
METHODS:
Data will be drawn from Child Health CheckPoint's (n=1864) Life@25 data (ie handwriting sample where children were asked to write about their life at age 25) and the self-reported questionnaire that assessed adolescents' HRQL (CHU-9D, PedsQL). The student will make a major contribution to scoring Life@25 data and work closely with a strong interdisciplinary team.
IMPACT OF RESEARCH:
The study will likely draw international attention given the large, high quality data available. Findings are likely to be disseminated in a high quality journal and will inform our understanding of HRQL.
 

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62. Delving into adolescents' dispositional optimism/pessimism and exploring its social determinants in 11-12 year olds: a population-based study.

Dr Kate Lycett
Community Health Services Research
Population Health
E kate.lycett@mcri.edu.au

Professor Timothy Olds
School of Health Sciences
University of South Australia
E Timothy.Olds@unisa.edu.au

 

INTRODUCTION:
 Dispositional optimism or pessimism refers to an individual's tendency to generally expect positive or negative outcomes. It is thought to be reasonably stable overtime and is also influenced by interactions between environment and genetics. High levels of optimism have been shown to be associated with a range of positive outcomes (eg physically, psychologically and academically), while high levels of pessimism have been shown to be linked to poorer outcomes. Understanding the extent to which adverse or positive life events, social circumstances and strength of family and peer relationships impact on one's mindset as an optimist or pessimist would offer insights into how modifiable these mindsets are and could help guide programs to build more optimistic life views. Using rich qualitative data paired with lifetime data children from birth, collected across six waves, we have a unique opportunity to gain insights into the social determinants of Australian adolescents' dispositional optimism/pessimism.

RESEARCH AIMS:
To examine the social determinants of dispositional optimism or pessimism in Australian 11-12 year olds.
METHODS:
Using nationally representative data from 1,864 children, this project will draw on six waves of data collected biennially from the Longitudinal Study of Australian Children (eg adverse life events, number and quality of relationships, socioeconomic status) and its recent Child Health CheckPoint where children completed Life@25 (ie handwriting sample where children were asked to write about their life at age 25) at age 11-12 years. The student will make a major contribution to scoring Life@25 data and work closely with a strong interdisciplinary team.
IMPACT OF RESEARCH:
The study will likely draw international attention given the large, high quality data available. Findings are likely to be disseminated in a high quality journal and will inform our understanding of dispositional optimism/pessimism
 

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63. Changes in adolescents' time use over the past decade

Dr Kate Lycett
Community Health Services Research
Population Health
E kate.lycett@mcri.edu.au

Professor Timothy Olds
School of Health Sciences
University of South Australia
E Timothy.Olds@unisa.edu.au

 

INTRODUCTION:
How we spend our time has a major impact on our health and wellbeing. However, studying time use is inherently difficult as it relies on 24-hour recall in order to consider all activities, as one activity naturally displaces the other. Novel measures, such as the Multimedia Activity Recall for Children and Adolescents (MARCA), which collects information on 259 activities, now make this possible. Over the past decade there have been major shifts in adolescent time use, with social media and screen time playing a much larger role in the lives of young children and adolescents, and possible declines in levels of physical activity. We have a unique opportunity to examine changes in time use across three cohorts that all used the MARCA to assess changes in adolescents' time use over the past decade. Changes in time use patterns are often anecdotally discussed, however, few studies offer rich 24-hour time use data to quantify these changes.

RESEARCH AIMS: To examine changes in time use over the past decade in Australian age 11-12 year olds.
METHODS:
Using MARCA data from the Health Young Victorian Study (HOYVS; 2005), The National Survey (2007) and Australia's recent Child Health CheckPoint (2015) we can compare changes in time use in 11-12 year old children over the past decade. The student will work closely with a strong interdisciplinary team to conduct these analyses.
IMPACT OF RESEARCH:
The study will likely draw international attention given the large, high quality data available. Findings are likely to be disseminated in a high quality journal and will inform our understanding of time use.

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64. How early life factors influence cardiovascular function at age 11-12 years: a population-based longitudinal study

Dr Michael Cheung
Heart Research
Clinical Sciences
E michael.cheung@mcri.edu.au

Dr Kate Lycett
Community Health Services Research
Population Health
E kate.lycett@mcri.edu.au

 

INTRODUCTION:
Cardiovascular disease is the number one killer worldwide. Although overt disease usually presents later in life, there are strong grounds for believing that it has its origins in early life. Early life factors, such as birth weight and adverse life events, have been shown to predict adverse cardiovascular events in adulthood. However, few studies have considered whether early life factors predict cardiovascular health in childhood. This is an important limitation as studies focusing on adverse cardiovascular events are unable to account for a lifetime of confounding (eg smoking, stress and adiposity). Establishing whether early life factors predict cardiovascular health would offer novel insights into the genesis of disease. Using new technology, we have a unique opportunity to assess early life factors influence on arterial stiffness via a measure of pulse wave velocity, at age 11-12 years.

RESEARCH AIMS: In a large population study, we aim to quantity to the extent to which pulse wave velocity (as a measure of arterial stiffness) at age 11-12 years is predicted by early life factors.
METHODS:
Using nationally representative data from 1,500 children, this project will draw on six waves of data collected biennially from the Longitudinal Study of Australian Children (eg anthropometrics, birth weight, gestational age mode of delivery, diabetes in pregnancy, gestational age, and preeclampsia, growth trajectory, parental hypertension) and its recent physical and biomarkers module, the Child Health CheckPoint (pulse wave velocity) at child age 11-12 years. The project will suit someone with a strong interest in health and epidemiology who will work closely with a strong interdisciplinary team to generate appropriate analytic models.
IMPACT OF RESEARCH:
The study will quantify key environmental factors influences on cardiovascular health. Given the large, high quality data available, findings are likely to be disseminated in a high quality journal and inform policy.

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65. How 10-year diet and body composition trajectories influence bone health at two important life stages: Early adolescence and mid-life

Dr Kate Lycett
Community Health Services Research
Population Health
E kate.lycett@mcri.edu.au

INTRODUCTION:
Osteoporosis and osteopenia (low bone density) affect over two-thirds of Australians over the age of 50 and contribute a large burden of disease. Poor bone health has been described as a paediatric disease with geriatric consequences, because peak mass occurs in the early 20s and then gradually declines throughout the life course. How to optimise bone accrual in childhood and minimise bone attrition through adulthood are vital public health unknowns. Modifiable environmental factors such as diet and body composition could be important to both. In an era where dietary patterns have changed rapidly and overweight and obesity have reached record highs, understanding how and when diet and body composition patterns over time influence bone health at two stages of the life course - early adolescence and mid-life - is essential to optimise bone health.

RESEARCH AIMS:
In two parallel national cohorts (parent-child dyads), to examine the extent to which bone health, at both stages of the life course, is predicted by:
1) Trajectories of body composition and diet spanning the preceding 10 years, and
2) The combination of these factors using a model causal logic framework.
METHODS:
Using nationally representative data from 1,200 children and their parents, this project will draw on six waves of data collected biennially from the Longitudinal Study of Australian Children (diet, body composition, puberty) and its recent physical and biomarkers module, the Child Health CheckPoint (bone) at child age 11-12 years. The project will suit someone with a strong interest in health and epidemiology who will work closely with a strong interdisciplinary team to generate appropriate analytic models.
IMPACT OF RESEARCH:
The study will quantify key environmental factors influences on bone health. Given the large, high quality data available, findings are likely to be disseminated in a high quality journal and inform policy.
 

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66. How 10-year diet and body composition trajectories influence lung function at two important life stages: Early adolescence and mid-life

Dr Kate Lycett
Community Health Services Research
Population Health
E kate.lycett@mcri.edu.au

 

INTRODUCTION:
Respiratory diseases are the second leading cause of mortality and morbidity globally. While they typically present in late adulthood, susceptibility to respiratory diseases may be first established in childhood when the lungs are still developing, with potential for further modification throughout the life-course. Lung function has a strong genetic predisposition, but modifiable environmental factors such as diet and body composition are also thought to play a major role in optimising lung function, although their contribution is yet to be quantified. In an era where dietary patterns have changed rapidly and overweight and obesity have reached record highs, understanding how and when diet and body composition patterns influence lung function at two important stages of the life course could point the way to optimising lung function throughout life.

RESEARCH AIMS:
In two parallel national cohorts (parent-child dyads), to examine the extent to which lung function, at both stages of the life course, is predicted by:
1) Trajectories of body composition and diet spanning the preceding 10 years, and
2) The combination of these factors using a model causal logic framework.
METHODS:
Using nationally representative data from 1,800 children and their parents, this project will draw on six waves of data collected biennially from the Longitudinal Study of Australian Children (dietary patterns, body composition) and its recent physical and biomarkers module, the Child Health CheckPoint (state-of-the-art lung function data) at child age 11-12 years. The project will suit someone with a strong interest in health and epidemiology and will involve working closely with a strong interdisciplinary team to generate appropriate analytic models.
IMPACT OF RESEARCH:
The study will quantify key environmental factors influences on lung function. Given the large, high quality data available, findings are likely to inform policy to optimise respiratory health and be disseminated in a high quality journal.

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67. Unnecessary use of pathology testing in hospital admissions.

Dr Kim Dalziel
Community Health Services Research
Population Health
E kim.dalziel@mcri.edu.au

Ms Rachel Neely
Community Health Services Research
Population Health
E rachel.neely@mcri.edu.au

Dr Helen Savoia
Head of Pathology,
The Royal Children’s Hospital
E helen.savoia@rch.org.au

 

BACKGROUND:
Across the developed world, there is growing interest in identifying and reducing unnecessary medical tests. For children, these tests can include blood tests that do little to change management but may cause harm to the child (pain) and healthcare system (increased costs).
Aims: To identify conditions for which children are admitted for a short stay (as a marker of disease severity), and then for the 4 most common conditions, identify (i) commonly ordered pathology tests, (ii) the proportion of these tests which are truly abnormal, and (iii) factors associated with unnecessary tests (i.e. tests which are normal).
Hypotheses: In a sample of children admitted for unplanned, brief stays at the RCH, the proportion of unnecessary pathology testing will be high for common conditions and factors associated with unnecessary testing will include child age (younger child), presence of IV cannula, and admission type (medical > surgical).

METHODS:
3-month prospective audit drawing upon inpatient admission data recorded in Epic. Patients with planned admissions for chronic illnesses (eg chemotherapy) will be excluded. Bivariate analysis to determine child (eg age, gender, family SES), clinician and other factors (seasonality, IV cannula presence) associated with increase ordering of unnecessary pathology testing. Logistic regression to determine significant factors associated with unnecessary pathology testing. Cost analysis of unnecessary testing, scaled up to healthcare system costs over 1 year. Interest and time permitting, interviews with 5 key hospital clinicians to determine why they request unnecessary pathology testing.
OUTCOMES/SIGNIFICANCE:
Before trialling interventions to reduce unnecessary pathology testing, we first need to identify which children and which conditions are associated with unnecessary testing and any potentially modifiable risk factors associated with unnecessary testing. Results will inform a peer-reviewed publication and a planned randomised controlled trial of an intervention to reduce unnecessary testing.

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74. Unnecessary use of imaging testing in hospital admissions

Dr Kim Dalziel
Community Health Services Research
Population Health
E kim.dalziel@mcri.edu.au

Ms Rachel Neely
Community Health Services Research
Population Health
E rachel.neely@mcri.edu.au

Available as Masters Project: Yes

BACKGROUND
Across the developed world, there is growing interest in identifying and reducing unnecessary medical tests. For children, these tests can include imaging tests that do little to change management but may cause harm to the child (radiation) and healthcare system (increased costs).
Aims: To identify conditions for which children are admitted for a short stay (as a marker of disease severity), and then for the 4 most common conditions, identify (i) commonly ordered imaging tests, (ii) the proportion of these tests which are truly abnormal, and (iii) factors associated with unnecessary tests (i.e. tests which are normal).
Hypotheses: In a sample of children admitted for unplanned, brief stays at the RCH, the proportion of unnecessary imaging testing will be high for common conditions and factors associated with unnecessary testing will include child age (younger child) and admission type (medical > surgical).

METHODS
3-month prospective audit drawing upon inpatient admission data recorded in Epic. Patients with planned admissions for chronic illnesses (eg chemotherapy) will be excluded. Bivariate analysis to determine child (eg age, gender, family SES), clinician and other factors (eg seasonality) associated with increased ordering of unnecessary imaging testing. Logistic regression to determine significant factors associated with unnecessary imaging testing. Cost analysis of unnecessary testing, scaled up to healthcare system costs over 1 year. Interest and time permitting, interviews with 5 key hospital clinicians to determine why they request unnecessary imaging testing.

OUTCOMES / SIGNIFICANCE
Before trialling interventions to reduce unnecessary imaging testing, we first need to identify which children and which conditions are associated with unnecessary testing and any potentially modifiable risk factors associated with unnecessary testing. Results will inform a peer-reviewed publication and a planned randomised controlled trial of an intervention to reduce unnecessary testing.

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68. Insights into the conundrums of managing mild congenital hearing loss

Dr Valerie Sung
Community Health Services Research
Population Health
E valerie.sung@mcri.edu.au

 

INTRODUCTION:
Congenital hearing loss (CHL) affects 1-3 in 1000 children. Over the last decade, universal newborn hearing screening has enabled early diagnosis of CHL, including mild CHL, in infants as young as a few weeks old. This has transformed the life chances of infants with moderate to profound CHL by improving language outcomes through early aiding and cochlear implantation. However, there has not been the same positive shift in outcomes for children with mild bilateral CHL despite earlier diagnosis, and it is unclear whether early fitting of hearing aids offer long-term benefits or unintended negative effects. This is despite clinical practice shifting towards offering hearing aids to these infants without established evidence of benefits or lack of harm, possibly contributing towards unnecessary health care costs.

RESEARCH AIMS:
To explore and describe, in infants with bilateral mild CHL, the
a) Factors influencing audiologists' decisions to offer/not offer hearing aids; and
b) Parental experiences of management options offered and associated positive/negative impacts.
METHODS:
Qualitative study. Structured focus groups (audiologists)/ telephone interviews (parents/carers). Audiologists are invited to participate through email correspondences through Australian Hearing. Carers of infants
IMPACT OF RESEARCH:
The study will give unique insights into why audiologists do/do not offer hearing aid fitting to infants with bilateral mild CHL, and explore carer experiences of the pros and cons of being offered hearing aids. The results will inform the piloting of a randomised controlled trial of offering/not offering hearing aid fitting to infants with bilateral mild CHL, to ultimately answer the question of whether hearing aid fitting will improve outcomes for children with bilateral mild CHL.

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69. Evaluation of a new model of care for children with bowel and bladder dysfunction: pathways of care and patient experience.

Dr Misel Trajanovska
Centre for Community Child Health
The Royal Children's Hospital
E Misel.Trajanovska@rch.org.au

 

Bowel and/or bladder dysfunction (BBD) affects up to 6% of children. These children can have constipation, soiling or wetting problems that often occur together and cause a great deal of distress for families. A large number of children with BBD are referred to the Royal Children's Hospital (RCH), Melbourne. They may be seen in one (or more) of the following clinics: Gastroenterology, Renal, Paediatric Surgery, Urology, General Medicine, or Encopresis. Waitlists range from seven months (Enuresis clinic) to 12 months (Renal clinic) and there are few guidelines to work out where patients should go and how they should be managed.

The project aims to evaluate a new model of care implemented to streamline referral and care pathways for children who are referred to RCH specialist clinics for bowel and bladder dysfunction. The prospective student will undertake an audit of hospital records to evaluate wait times and care pathways post implementation of the new model. Patient experience will further be explored through clinic surveys used to capture satisfaction rates from wait list to receiving the service and quality of life.

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70. Trends in additional health and developmental needs over time: Evidence from three cohorts of the Australian Early Development Census

Dr Meredith O'Connor
Policy, Equity & Translation
Population Health
E meredith.oconnor@mcri.edu.au

 

The Australian Early Development Census (AEDC; www.aedc.gov.au) is a population measure of children's development - including their language and cognitive skills, social competence, emotional maturity, physical health and wellbeing, and communication skills and general knowledge - completed by teachers for all children in their first year of school across Australia. It also includes information about children's additional health and developmental needs (AHDN), including children's special needs status, the impact of health problems on their school functioning, and whether they require further assessment. The AEDC is completed every three years, and data is now available from 2009, 2012, and 2015, with over 250,000 children in each cohort. This provides a rare opportunity to examine trends in AHDN over time across these cohorts, including areas of difficulty like language and behavioural issues and actual diagnoses as reported by teachers, for both the full population and vulnerable groups such as those living in disadvantaged communities. The results will contribute to understanding the support needs of Australian children starting school.

This project involves quantitative analysis of existing data using Stata software. Ethics approval for this project has been granted by the Royal Children's Hospital HREC.

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